NPIMap

Individual provider Active NPI

Kaitlyn Ashley Sikkema

  • Speech-Language Pathologist
  • Severna Park, MD
National Provider Identifier
1013263375
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
06932 Issued in MD
Practice address
645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931
Phone
(410) 544-2500
Fax
(410) 384-9703
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 06932 MD Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931

Mailing address

645 Baltimore Annapolis Blvd
Ste 111
Severna Park, MD 21146-3931
Phone (410) 544-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1013263375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "STE 111",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "410-544-2500",
            "fax_number": "410-384-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "STE 111",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463931",
            "telephone_number": "410-544-2500",
            "fax_number": "410-384-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKKEMA",
        "first_name": "KAITLYN",
        "middle_name": "ASHLEY",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "06932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.